State-Mandated Counseling Lowers Vaccine Exemption Rates

With the mandated counseling, there was a reduction in geographic clustering of vaccine exemptors.

HealthDay News — Implementation of Washington state's Senate Bill 5005 (SB5005), which requires counseling and a signed form from a licensed health care provider to obtain a vaccine exemption, was associated with a decrease in exemption rates and an increase in vaccine coverage for vaccines required for school entrance, according to a study published in Pediatrics.

Saad B. Omer, MBBS, MPH, PhD, from Emory University in Atlanta, and colleagues examined the impact of SB5005 on immunization coverage and exemption rates in Washington State from school years 1997-1998 to 2013-2014.

The researchers found that there was a significant relative decrease of 40.2% in exemption rates after implementation of SB5005, translating to a significant 2.9-percentage-point absolute decrease. Increases in vaccine coverage were seen for all vaccines required for school entrance, except the hepatitis B vaccine.

After implementation of SB5005, there were decreases in the probability that kindergarteners without exemptions would encounter kindergarteners with exemptions and the probability that kindergarteners with exemptions would encounter other kindergarteners with exemptions. There was also a reduction in geographic clustering of vaccine exemptors in association with SB5005.

"States in the United States and jurisdictions in other countries should consider adding parental counseling by health care provider as a requirement for obtaining exemptions to vaccination requirements," the authors write.

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